If oral implants are placed between the mental foraminae in the mandible older turned implants display similar success rates as do modern devices. However, if any compromised situations such as patient smoking, placing implants in the maxilla or applying direct loading, then modern implants outperform their predecessors significantly. Changing surface microtopography to a moderately rough one is the only surface alteration with demonstrated clinical improvements, but it is possible that alterations in surface chemistry, physics or nano-roughness may have an impact as well. Previous clinical hypotheses of a great incidence of peri-implantitis around commonly used implant surfaces are incorrect; in fact a summed frequency of implant failure and peri-implantitis of within 5% at 10 years or more of follow up is a much more realistic figure than previously reported data. Having said this, in the light of many millions of oral implants being placed annually, peri-implantitis may still represent an important clinical problem. Osseointegration is but a foreign body reaction and to minimize future problems with peri-implantitis, it is important to realize that this problem of a foreign body nature is quite unreated to a disease of teeth named periodontitis.
Tomas Albrektsson has worked a few years with oral implants. He is an MD, professor emeritus of Gothenburg University and visiting professor of the department of prosthodontics at Malmö University in Sweden as well as being an Honorary Doctor of the Royal College of Physicians and Surgeons of Glasgow (RCPSG) and of the Buenos Aires University of Argentine.